The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Thursday, February 08, 2007

What Bugs Me Today II

I couldn't believe it when I stumbled across this British medical student's shameless plea for donations. I'll give you the recap so that you don't need to click on it and drive up this loser's hit count-- he's a 4th year medical student in Manchester, U.K. (over there it's a 5 year program) and he's nearly 30,000 British pounds in debt. He's begging randomly to the internet community to send him donations because he doesn't want to 'graduate in debt'.

Please. Call the whaaaaa-mbulance. In Canada, since deregulation of medical school tuition in the mid-1990's a student would be unbelievably lucky to finish medical school with only 60K in debt (assuming the very rough conversion of 1:2 for British pounds to Canadian dollars). Not to mention the fact that we then have to make payments on this debt as we complete anywhere from 2-6 years of residency at which time our pay starts at $45K yearly. In fact, if you divide the weekly salary by the average number of hours a medical resident works in a week, we almost make minimum wage.

I admit, my debt is on the high end of normal. I didn't have a family to support, so I don't have that excuse, but I did put myself through a master's degree and a second undergraduate degree before medical school without outside assistance. And until the government student loan program wakes up and realizes that the max allowance of 10K a year is ridiculous for a medical student (whose yearly tuition and fees nearly doubles that and it's not like we have the flexibility in our schedules to work-part time through school), the bulk of my debt is with the bank. I could sell my first, second and third born to the bank and I'd still end up owing them in the end.

I don't usually feel sorry for myself when it comes to my financial situation. I don't begrudge the loan system-- without it, medical school wouldn't have been an option for me. I don't even resent the amount of tuition that we're expected to pay-- even my $16K yearly tuition is heavily subsidized by the Canadian taxpayers. But it's difficult to keep your head above water for the first few years making payments that eat up 50% of your take-home salary.

On one hand, I think it deters people from primary care (family medicine, pediatrics) where salaries are traditionally lower and overhead traditionally higher. But on the other hand, I wonder how my specialist colleagues in 5 and 6 year residencies can manage with the high debt and low salary for even longer than I have to.

I don't love being my age (i.e. not a spring chicken) still having to rent. There is so much travelling I want to do but unless it involves camping and is accessible by car it's unlikely to happen any time soon. Even having a baby may strain the finances more than I care to think about. But as long as I manage to make ends meet until I'm making real money, I know the debt will be manageable. It just means our first house will be small, we'll make due with our car until it dies a natural death, we won't be taking any vacations and we won't be contributing to RRSP's until we're in our late 30's. But that's not so bad, right? Um... right?

I guess that's why people like this guy irk me so much. What makes HIM so special that he deserves to graduate debt-free? Why shouldn't he have the same concerns as the rest of us who chose a life in medicine regardless of a distinct lack of rich relatives? I don't begrudge the people who had a hand in getting through school-- but I don't think I would have asked it of my parents even if they COULD afford it.

I just wish people would stop assuming that Mr. Couz and I are on easy street because of my title. Trust me... right now, it's no financial windfall.

(Thanks to Kevin, M.D. whose post brought this wing-nut to my attention)

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Blogger Nikki said...

Oh, how I would like to send this post to my entire extended family and a good chunk of my friends. It drives me nuts when someone says, "yeah, but you're going to make tons of money and earn it all back in no time," every time the topic of med school debt comes up. $150K is not small change, for anyone!

My friends who work in business will always be miles further ahead financially than I am - and no one ever tells them how rich they are!

6:31 PM

Blogger Psych-o by now said...

Hmmm...seems like he has an inflated sense of entitlement.
All graduate education in Canada is very expensive when factoring the yearly increases.

6:57 PM

Anonymous Anonymous said...

What a bunch of crap. I have a measly BA and MBA and racked up debt close to $70k. My family paid for nothing and I worked full time during grad school cause you know, I had to eat.

Law school is starting soon and I am paying that on my own while still paying for my undergrad and graduate degrees. I dont feel bad at all for Begging Med Student. Suck it up like the rest of us.


7:05 PM

Anonymous Anonymous said...

Well, he's entitled to beg if he wants. If people want to donate to him they should be allowed, no? I didn't go to his site, but was he saying that he's worse off than everyone else, or was he just asking for assistance?

I'll be finishing a measly undergrad at least $45,000 in debt due to me not being able to narrow my interests down and prolonging the damn thing to 6 years. I'll be 28 by the time I graduate and then maybe I'll do my masters, but I too am getting awfully sick of renting. It's not nearly as bad as grad school, but it still sucks. Especially since I could have finished this thing before the rates went up so much.

7:31 PM

Blogger A girl said...

Good timing, Couz.

Today was due date for tuition in my school. I never spent so much money in one click - here they go - thousands of dollars. Going, going, gone... I took 5 minutes to check how much money I borrowed so far... I am half way through 3rd year and have over 100K debt. Most of it with the bank. And this is probably an average for my classmates. We are getting paid during the clerkship - hilarious 240$ every 2 weeks... my interest to the bank is 300$ monthly...

Lots of people think that we will pay it back easily because we are going to be making LOTS of money, right? I met a family doc another day who had so much financial problems that he was forced to close his office. He is working as surge assist now. The overhead and medschool debt killed him.

I am amused that someone would actually ask total strangers for money so he can graduate without debt. He may as well stand on the corner. Pathetic.

Meantime, I am getting ready to be poor for a long long time. RRSP? Place to live? Not so much. I hope my car doesn't break down. OOPS don't want to jinx it.

10:41 PM

Anonymous Anonymous said...

Almost all students are poor, almost all students have debt. Almost all entry-level positions (ie. first few years out of school) pay 40k. We're lucky if we can find education-related jobs after 6 months of looking. Eventually, we get through it.

12:14 AM

Anonymous Anonymous said...

I'm a Canadian living in Britain and trust me you would not BELIEVE the sense of entitlement that people have here. About education, health care, jobs, housing and everything else. This is just typical.

4:14 AM

Blogger ERnursey said...

It's nothing for American doctors to graduate with debt of a couple hundred thousand dollars.

10:46 AM

Anonymous Anonymous said...

Thanks for the post...I can totally relate. When people ask what I do (I'm a med student) and what my husband does (he is a newly minted dental hygienist) they always reply "You must be rich!" It drives me nuts. If I try to explain our debt load I feel like a whiny baby, but sometimes the stress of living paycheck to paycheck (my husband's income thankfully covers our living expenses) really get one down. True eventually we should have a comfortable life, but in the mean time there isn't a lot of money left over to enjoy the little things in life.

10:59 AM

Anonymous Anonymous said...

I don't know why people think that med students are rich. It must be television or something. I wonder if law students get this attitude, or architecture students?

11:34 AM

Anonymous Anonymous said...

Why did they even deregulate med school tuition anyway? Was this at the same time that happened to all tuition?

11:37 AM

Blogger MedStudentGod said...

American medical student here - debt will be over $250,000 due to family and other obligations. Begging Medical Student can go jump off the London Bridge for all that I care.

1:57 PM

Blogger PK said...

I'm an American medical student and am $25,000 in debt after only one year at a public medical school. Over here you can't get out with less than $100,000 of debt.

5:35 PM

Anonymous Anonymous said...

Yes, law student run into the same issue as med student, everyone thinks we are rich. Not so rich after paying school loans!

5:43 PM

Anonymous Sara said...

He's taken down the request for donations - seems the commenters have shamed him into changing his mind about that particular "social experiment."

8:41 PM

Blogger Judy said...

I'm a first year medical student here in the United States. I must say that not considering my previous debt, I will owe over $280k principal with over $607k interest, with a total of over $888k. That is for our D.O./M.B.A. dual program.

11:50 PM

Blogger Couz said...

Holy shit. Judy wins.

But I'm a little jealous. Much of my stress currently comes from the fact that the bank says it won't lend me any more money. I don't worry so much about being able to pay it back, I worry more about managing on my current salary to maintain the debt until I'm in a position to pay off the capital. I think I need to talk to Judy's bank. ;-)

8:21 AM

Anonymous Jarrad Maiers said...

2nd year med student. I worked my way through a cheap college so that I could start medical school with no debt at all. But by the end of it, I'll be $250,000 in debt.

I'm planning on selling my left leg to pay it off. Anyone need a left leg?

1:58 PM

Anonymous Anonymous said...

That med student does not represent the average Brit, or indeed medical student that I know. Most medics that I know aren't too upset by £30,000 of debt because they know they will earn reasonable money later. Even starting salaries aren't 'too' bad here for junior doctors.

The reason why we Brits are pissed off about student debt which Canadians/USians think is nothing is because of a number of factors. The government that introduced fees:
1) said they wouldn't before election in 1997,
2) said they would remain at the original payment,
3) Almost all went to university themselves paying no fees and in many cases got grants to cover them. Some of them were from VERY wealthy backgrounds and paid no fees, and others were from very poor backgrounds and were the first to go to university, and would not have done with 'fees' and no grants!

Our banks won't lend us the kind of money you Canadians/USians talk of. I reckon my generation paying £1000-1250 a year could get a total of £13,000 in loans and maybe £2000 in overdrafts for a four year degree course.

Assuming £75 a week average rent in the UK (London, Bristol are much higher) then that is £3900 a year in rent alone. That is before travel, food, upfront fees, and other costs.

Even working part time you'd be lucky to make £2-3000 a year.

Four times say £4000 is £16,000. That's the entirety of the student loan AND overdraft.

Leaving £8-12,000 for other living costs with £12,000 being unusual over the four years of this hypothetical degree. That has to pay all the bills, transport, food, studying costs etc etc. My bills at university were between £1200 and £2000 a year. The numbers are tight, and I did not live in an expensive city.

Yes we can work part time, but there are often limited jobs available especially in 'university cities' like mine which have two large universities full of students wanting work.

Many universities do not permit students to work more than 15 hours a week, and employers often won't employ students who cannot to work less than 25 hours a week. So choose between getting kicked off your course, or losing your job!

Oxbridge (like Ivy league) don't permit their students to work during term time at all, you can get kicked out for it. More universities are considering this option as working students do not get as good grades as they ought.

Once you use up all the money you can earn, loans and borrowing from the bank that is it. If like me you have health reasons which prevent you working and doing university, you are totally at the mercy of parents.

I was meant to be in the first year of students to pay fees. I deferred by a year for other reasons, but many of my friends parents struggled to find £1000 with less than 6 months notice (we didn't think fees would get bought in, as it was horribly unpopular and badly implemented) on top of £1000 hall fee deposits and other 'initial' costs. The so called paying in installments didn't work in the first year and many people had to find £8000 to start their courses due to cockups.

We didn't have a lifetime of expectation to save up for university. Until 1998 very few people paid fees, and most people got some kind of grant. The academics at university don't support fees either, as students are now demanding better services for 'extra' money that university departments don't see.

It should also be taken into account that the average cost of living in the US and Canada is substantially lower than in the UK in many areas. Our rent is comparatively high, as well as taxation rate.

We don't get 'free' healthcare, we pay for it with taxes. Many people do degrees which will not get them highly paid jobs. At least medicine will pay reasonably well eventually. Especially compared to say occupational therapy, nursing and teaching.

It isn't about entitlement, it is about poorly thought through political processes and the devaluation of university degrees as a whole.

5:55 PM

Anonymous Anonymous said...

I forgot to make it clear that we had to find £1000-1250 up front for university each year which also had to come out of those calculations that I showed.

The current situation is that fees are now nearer £3000 a year but some or all of it is deferred until /after/ graduation like repayment of the student loans.

I don't know if current students have access to other loan sources which mine didn't.

5:57 PM

Anonymous Anonymous said...

anon 5:57 - Don't worry, I can sympathize. A lot of Americans (and I guess it's catching on here in Canada too) talk of this "sense of entitlement" when it comes to helping eachother out, but they themselves feel entitled to complete freedom without giving back to the society that facilitates that freedom.

3:51 PM

Blogger Kate said...

The term whaaaaa-mbulance just made me laugh out loud. I really can't believe that guy. I mean, I'm all for getting money the easiest way possible but this is incredibly cheeky. 30K is nothing, even in pounds. My boyfriend is british and has more debt than that after finishing his engineering degree and he's not crying about it. I think doctors are pretty lucky that they can pay their debt off so quickly compared to some other students who live their whole lives shouldering the burden because the jobs they got after their degrees are lower paying (my friends who went to film school for example and live off grants). Yes, it's hard to pay it off, but eventually we'll all make good money and be pretty comfortable, which I feel very lucky for.

1:45 PM

Anonymous Anonymous said...

What a sensitive issue. I'll bet that most careers, where a large amount of money needs to be forked over to learn, start off slow in the earning department.

Take pilots for example. There is a misconception there too that we earn a ton, and travel anywhere. Well, if you're part of my family, you'll know that's not true. It's not until you're in the final few years of your career (with mandatory retirement at age 60), that you make the big bucks.

I can totally sympathize wtih the doctors and lawyers out there. I have a very good friend who is a practicing lawyer, with a very good firm, and has been a member of the bar for about 5-6 years, and is still paying off student loans.

Keep your chin up - it will get better.

8:39 PM

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10:38 AM

Blogger doctor T said...

Correct me if I'm wrong, but once you're a resident you no longer pay tuition fees, no? That's where the gap between other graduate students and medical students widens -- non-meds are still making $12-15,000 a year until they are totally done their degree (average of 6 years in my field), paying tuition every year ($6000 a year in my program), and when we finish we're lucky if we start out at $50,000 a year. For me, loans were inevitable -- my parents help but I'm married, and my husband isn't in a high-paying line of work. My debt won't be as high as most med students, but my pay will never be as high either.

6:29 PM

Anonymous Anonymous said...

I'm going into my 3rd year of med school now, and by the end of it all, I'll probably be close to $150K in debt. That's not no small bit of change, but in the grand scheme of things, it's not really all that much.

Consider this. As a resident, we'll be making $40-50K/yr for an average of 3 years. After that, however, the mean salary is close to $150K/yr. Put the majority of that $150K into debt repayment and you're practically debt free. I don't really see why people are complaining!

10:19 PM

Anonymous monash medical student said...

maybe he should post lingerie pictures like Dr. Izzie in Grey's Anatomy to get out of debt. or fall in love with a millionaire like Danni who will give you a cheque of 8.7 million dollars when he dies.

7:40 PM


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